COMMUNICATING WITH YOUR MEDICAL TEAM
BY JANET HAMILTON, MA, RCEP, CSCS
Most of us at one time or another have stepped out of a doctor's office and on the way home remembered a question we meant to ask. Worse still, we asked the questions we wanted but we're not sure we understood the answers. This breakdown of communication between medical professionals and their clients is all too common. Non-compliance, the medical term for not doing what you were told to do, is sometimes due to just not understanding the information provided.
Choosing your medical professional
It seems obvious but, the first step in good communication is finding someone you can communicate with well. Making the right choice of medical professional involves consideration of several factors, starting with any restrictions placed on you by your insurance carrier. Make sure to read your insurance booklet thoroughly. Some insurance companies will allow you to see a professional outside of their "network of providers", but they may not reimburse you as well for your expenses. Other policies may allow you full freedom of choice in some professionals - i.e. medical doctors, but limited choice in others - i.e. physical therapists. So the first step in choosing a medical professional is to check your insurance policy for restrictions.
Next, it's a good idea to talk to friends and relatives in your geographical area and find out if they have good things to say about the individuals they are seeing. Sometimes it helps to ask other athletes that you train with - they may have had similar experiences and be able to steer you in the right direction.
Finally, when you're ready to make the decision, make a few phone calls first. Get a feel for how the front office personnel respond on the phone. Were they polite? Were they willing to answer questions? Did they offer to send you a brochure or more information about the services available? Ask them questions like: How long has the doctor (or therapist, or whatever) been in practice? What is their area of specialty? Do they regularly attend meetings and continuing education courses? Don't forget double check about whether they accept your insurance carrier or not, and ask if they will file for you.
You've narrowed your search, and made an appointment, but the interview process isn't really over until you meet the practitioner face to face. This is where it sometimes is a matter of trusting your gut feelings. If you've been referred to them from a current client, mention that person's name and tell them that you heard of them through this person - ask if they have time to answer a couple of questions. Tell them up front that you're an athlete and you are interested in working with a medical professional to make sure that you're able to pursue your sport for as long as you possibly can. Then ask the questions that are really pressing on your mind - the following ones are only examples, yours may be very different!
- Do you see many athletes in your everyday practice? (You hope to hear that they see some; but realize that since athletes are generally healthy, they don't go to medical professionals often and therefore they may have a practice that is mostly made up of a non-athletic population,)
- What do you do to stay fit? (Most of us want to see a medical professional with like-minded tendency to try to stay fit.)
Discussing your options
To overcome the white-coat brain-fade that seems to occur so often, take a few moments to prepare yourself before you go. The week before your scheduled appointment, carry a notepad with you and whenever a question about your condition pops into your mind write it down. Don't worry about duplicates just yet, you'll take care of those later. The questions will be unique to you and to your condition, so use the ones below only to stimulate your thought processes.
- How many athletes with my particular condition have you seen in the last year?
- What do you think are the factors that cause this condition in the first place?
- What was the worst outcome you've seen from this condition?
- What was the best outcome?
- If I follow your directions to the letter, how long before I can begin my sport (running, walking, biking, whatever) again?
- Can I cross train? If so are there any restrictions as to what I can do?
- Who would you see if you had this condition?
Take your list of questions with you when you have your appointment. You will also want to take your training log with you - though the practitioner may or may not ask for it. They will most likely appreciate the fact that you have come well prepared and be more willing to answer questions. As you ask the questions, listen closely to the answers and take notes - making sure to ask for clarification if you don't understand things. Sometimes it helps to summarize the response back to the practitioner, just to make sure you're both on the same page. For example, you may say something like: "I think I understand you to say that my only real option is surgery, and the sooner the better." To which the doctor may say "I think that's best, but you're welcome to try just rest and medication for a few weeks to see how you do."
It is always a good idea to get a second or even a third opinion when considering surgical intervention for a condition. If your doctor is recommending surgery, feel free to ask them who they would go to themselves if they needed this particular surgery. If you then go to that individual for a second opinion, ask them the same question and see where they would go. If you have 2 or more doctors recommending the same treatment, you can be much more comfortable in your decision to go under the knife. Unless it is an emergency, the time you spend researching your condition and those who will be caring for you is time well spent.
You've taken the time to see a professional and they've given you their opinion on what needs to be done. Now it is up to you to follow through. If you've been told to take medications, make sure to ask specifically about side effects and dosages. Review this information with the pharmacist when you fill the prescription. If you've been instructed to make changes to your training schedule, make sure you're clear about restrictions and any guidelines on returning to your activities. If you've been given specific exercises to do, make sure you're clear about how often you're to do them and that you're comfortable with the techniques. More than anything, make sure you feel comfortable with calling the practitioner about any questions you may have after leaving their office. The confusion you have about something can often be easily cleared up over the phone.
Patience - A major virtue!
Most injuries take time to heal - usually considerably more time than we'd like. The amount of time depends on the injury, your age, your nutritional status, your fitness level prior to the injury and a whole host of other variables; only some of which you have control over. You must be patient and persistant at this point. Follow instructions closely, and do your homework. Keep a log of how you're doing, what symptoms you're experiencing and what activities you're able to do. This log will enable you to see incremental changes in your condition that might otherwise go without notice. Simple notes like: "able to climb 2 flights of stairs painfree today" will help you to see your progress and minimize your frustration. You can speed your recovery by maintaining adequate nutrition and hydration levels, avoiding smoking (interferes with blood flow), and avoiding activities that bring on symptoms. Remember, pain is usually your body's signal to stop - listen to it!
To your success! - Coach Janet Hamilton, MA, RCEP, CSCS